CoverMyMeds’ Post

Field Reimbursement Management and Field Access Management are vital to bridging the gap between pharma companies, payer landscapes and providers. They bring excellent continuity and outcomes of patient onboarding. Excellent article about this field.

Field Reimbursement Managers (FRMs) play a crucial role in bridging the gap between pharmaceutical companies, insurers, and healthcare providers. @CoverMyMeds’ latest article explores how FRMs’ expertise can simplify reimbursement processes and help overcome the barriers that stand between patients and their therapies. https://lnkd.in/e3meHtbm

What is a PBM? Pharmacy Benefit Managers (PBMs) have existed since the 1960s, when they were created to help insurance companies manage prescription drug costs. Often called the “middleman” of the US pharmaceutical industry, PBMs today are third party administrators that exist between community pharmacies and insurance companies, as well as between insurance companies and drug manufacturers. PBMs negotiate the terms for prescription drug access for hundreds of millions of Americans and wield enormous power over patients’ ability to access and afford their prescription drugs. In short, PBMs significantly influence what drugs are available, where, and at what price.

Pharmacy Benefit Managers (PBMs) have been one of the most powerful and least discussed segments of the healthcare industry – until recently. Over the last year, PBMs have been investigated by both the press and Congress. Now, the Federal Trade Commission (FTC) has turned its attention their way. The FTC claims that the three largest PBMs – CVS Caremark, Express Scripts, and OptumRx – are manipulating the market by steering patients towards more expensive drugs, driven by higher rebates from manufacturers, and excluding cheaper alternatives from their formularies. Their investigation aims to bring transparency and fairness to the prescription drug market, addressing the conflicts of interest and high costs burdening consumers. But we didn’t get here overnight: in fact, the history of PBMs is closely linked with the evolution of the pharmaceutical industry. Unfortunately, like many segments of the healthcare industry, PBM’s recent move toward consolidation – driven by an interest in driving growth and minimizing competition – has caused them to stray from their original purpose. And consumers are paying the price. At its core, this investigation underscores the need for broader healthcare reform to address the root causes of high drug prices and find innovative solutions to improve access to affordable medications. Read more about how we got to this point and what it will take to enact meaningful change in my latest Forbes column – linked below. #healthcare #pharmaceutical #PBMs #FTC

As policymakers consider PBM reform, a new article from #USCSchaeffer Center experts outlines 5 key principles to ensure that patients benefit from any comprehensive overhaul. The recommendations are informed by nearly a decade of research into the increasingly complex and opaque world of PBMs and other parts of the pharmaceutical distribution system. A top-line summary of the five principles: 1. The PBM industry is highly concentrated, and often this market power works against patient interests. 2. Congress must anticipate how businesses will react to new regulation. 3. Price transparency is Congress’ best avenue for making markets work better. 4. Patients need to see immediate savings. 5. PBMs should have fiduciary responsibility to their clients. Learn more: https://lnkd.in/gbYBPZ4E USC Sol Price School of Public Policy USC Alfred E. Mann School of Pharmacy and Pharmaceutical Sciences

These are common sense policy reform principles from #USCSchaeffer. Number 4 is a key principle - patients’ pharmacy benefits should work for them.

https://lnkd.in/gkeH78Rv Breaking news, Gavin Newsom vetoes the PBM reform bill (link to his response provided below). Does the Governor of California really have a clue about the pricing of pharmaceuticals and the role of PBMs? What would happen to drug costs and reimbursement rates if PBMs were removed from the equation? Please feel free to leave a comment. #805pharmacist

Discover how Austria's pharmaceutical policy shapes access to medications and controls costs. 🇦🇹💊 Our latest article unpacks the nation's approach to pricing and reimbursement. #HealthcarePolicy #PharmaTrends #PharmaMarketAccess #HealthcareInnovation 👉 Read the full analysis and learn how these strategies could inform global healthcare practices https://lnkd.in/e5nxYZjF

Thoughts on this? >> Three Areas to Watch: The Inflation Reduction Act and Prescription Pricing >> Comment below! >>> lqventures.com #strategy #competitiveintelligence #marketing #healthcare #biotech #pharmaceutical #productmarketing #pharma